1.The role of CYP2E1 in trichloroethylene-induced skin sensitization and liver damage in guinea pigs
Lijuan WU ; Xiangrong SONG ; Fengrong LU ; Hongling LI ; Jiaheng HE ; Xiao ZHANG ; Hailan WANG
China Occupational Medicine 2025;52(3):249-256
Objective To investigate the role of cytochrome P450 2E1 (CYP2E1) in trichloroethylene (TCE)-induced skin sensitization and liver damage in guinea pigs, using diallyl sulfide (DAS), a CYP2E1 inhibitor, as an intervention. Methods Specific pathogen-free female guinea pigs were randomly divided into blank control group, solvent control group, positive control (2,4-dinitrochlorobenzene) group, TCE-exposure group, and DAS-intervention group. Skin sensitization experiments were conducted using the guinea pig TCE maximal dose-skin sensitization test. Urinary trichloroacetic acid levels were determined following TCE induction and challenge. At 48 hours after the final challenge, serum liver function markers and inflammatory cytokines levels were detected. Histopathological examination on skin and liver tissues was performed, and hepatic CYP2E1 protein expression and oxidative stress indicators were assessed. Results The sensitization rates of guinea pigs were 100.0%, 75.0%, and 33.3% in the positive control, TCE-exposure, and DAS-intervention groups, respectively, while the blank control and solvent control groups were both 0.0%. Compared with the guinea pigs in TCE-exposure group, those in the DAS-intervention group had lower urinary trichloroacetic acid levels at intradermal induction, local induction, first challenge, and 24 hours after the final challenge time point (all P<0.05). Histopathology of guinea pigs showed dermal inflammatory infiltration and basal keratinocyte necrosis in the TCE-exposure group, whereas only mild dermal inflammation was observed in the DAS-intervention group. The guinea pigs in TCE-exposure group exhibited diffuse hepatocellular necrosis, while hepatic damage in the DAS-intervention group was alleviated, characterized by only mild hepatocellular steatosis and hepatocyte swelling around the central vein. The skin sensitization rate of guinea pigs in the TCE-exposure group increased (all P<0.01), the serum alanine aminotransferase (ALT )activity, the levels of interleukin (IL)-2, IL-17, and tumor necrosis factor-α (TNF- α) increased (all P<0.05), the relative expression of CYP2E1 protein, the activity of superoxide dismutase (SOD), and the level of malondialdehyde in liver tissue increased (all P<0.05), while the activity of catalase decreased (P<0.05), compared with the blank control and solvent control groups. The serum ALT activity and the levels of IL-2, IL-17, and TNF-α of guinea pigs in DAS-intervention group reduced (all P<0.05), as well as CYP2E1 protein expression, SOD activity, and malondialdehyde level in liver tissue reduced (all P<0.05), compared with the TCE-exposure group. Conclusion TCE can induce hepatic CYP2E1 expression, thereby promoting oxidative stress and inflammatory responses, which contributes to skin sensitization and liver damage. DAS alleviates TCE-induced toxic effects on skin and liver by inhibiting CYP2E1 expression.
2.Construction and verification of a nomogram of factors influencing the risk of death in patient with sepsis-associated thrombocytopenia
Chao GU ; Han WANG ; Yanxiu LI ; Quan CAO ; Xiangrong ZUO
Chinese Critical Care Medicine 2024;36(2):131-136
Objective:To construct a nomogram prediction model for predicting the risk of death in patients with sepsis-associated thrombocytopenia (SAT) in intensive care unit (ICU) for early indentification and active intervention.Methods:Clinical data of SAT patients admitted to ICU of the First Affiliated Hospital of Nanjing Medical University from December 2019 to August 2021 were retrospectively collected, including demographic data, laboratory indicators, etc. According to the prognosis at 28 days, the patients were divided into the death group and the survival group, and the differences of clinical variables between the two groups were compared. Multivariate Logistic regression analysis was performed to analyze the independent risk factors influencing mortality of patients within 28 days, then a nomogram predictive model was constructed and its performance was verified with internal data. Receiver operator characteristic curve (ROC curve) was used to evaluate the diagnostic effectiveness of the nomogram model, and the clinical applicability of this model was evaluated by clinical decision curve analysis (DCA).Results:A total of 275 patients were included, with 95 deaths at 28 days and a 28-day mortality of 34.5%. Compared with the survival group, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), lactic acid (Lac), platelet distribution width (PDW) on day 5 of ICU admission, blood urea nitrogen (BUN), total bilirubin (TBIL), aspartate aminotransferase (AST), C-reactive protein (CRP) of patients in the death group were higher, activated partial thromboplastin time (APTT) and prothrombin time (PT) were longer, platelet count (PLT) on day 3 and day 5 of ICU admission, direct bilirubin (DBIL), fibrinogen (FIB) were lower, the history of chronic lung disease, mixed site infection, lung infection, bloodstream infection, Gram-negative bacterial infection and fungal infection accounted for a higher proportion, the history of diabetes mellitus, urinary tract infection and no pathogenic microorganisms cultured accounted for a lower proportion, and the proportion of the use of vasoactive drugs, mechanical ventilation (MV), continuous renal replacement therapy (CRRT), bleeding events and platelet transfusion were higher. Multivariate Logistic regression analysis showed that APACHEⅡ score at the day of ICU admission [odds ratio ( OR) = 1.417, 95% confidence interval (95% CI) was 1.153-1.743, P = 0.001], chronic lung disease ( OR = 72.271, 95% CI was 4.475-1?167.126, P = 0.003), PLT on day 5 of ICU admission ( OR = 0.954, 95% CI was 0.922-0.987, P = 0.007), vasoactive drug ( OR = 622.943, 95% CI was 10.060-38?575.340, P = 0.002), MV ( OR = 91.818, 95% CI was 3.973-2?121.966, P = 0.005) were independent risk factors of mortality in SAT patients. The above independent risk factors were used to build a nomogram prediction model, and the area under the curve (AUC), sensitivity and specificity were 0.979, 94.7% and 91.7%, respectively, suggesting that the model had good discrimination. The Hosmer-Lemeshow goodness of fit test showed a good calibration with P > 0.05. At the same time, DCA showed that the nomogram model had good clinical applicability. Conclusions:Patients with SAT has a higher risk of death. The nomogram model based on APACHEⅡ score at the day of ICU admission, chronic lung disease, PLT on day 5 of ICU admission, the use of vasoactive drug and MV has good clinical significance for the prediction of 28-day mortality, and the discrimination and calibration are good, however, further verification is needed.
3.Construction and Validation of A Prediction Model for Pulmonary Nodule Nature Based on Clinicopathological Features,Imaging and Serum Biomarkers
Rui YUAN ; Taoli WANG ; Wenhui YU ; Shunan ZHANG ; Shenghua LUO ; Yunlei LI ; Xiangrong WANG ; Jiachuan WANG ; Haitao GUO
Journal of Modern Laboratory Medicine 2024;39(1):146-151,157
Objective The study aimed to construct and validate a predictive model for pulmonary nodules(PN)nature based on clinicopa-thological features,imaging,and serum biomarkers,so as to provide scientificdecision-making for early diagnosis and treatment of lung cancer.Methods A retrospective was performed on 816 PN patients with definited pathological diagnosis who received surgical resection analysisor lung biopsy in the Department of Thoracic Surgery and Oncology of Shenzhen Traditional Chinese Medicine Hospital from January 2019 to February 2023.Among them,113 cases that did not meet the inclusion criteria were excluded,and the remaining 703 cases were included in the study.The study based on the clinicopathologic features(age,gender,smoking history,smoking cessation history and family history of cancer),chest imaging(maximum diameter of nodule,location of lesion,clear border,Lobulation,spiculation,vascular convergence sign,vacuole,calcification,air bronchial sign,emphysema,nodule type and pleural indentation,nodule number)and serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCA)in patients with PN.These cases were randomly divided into a modeling group(n=552,237 benign,315 malignant)and a validation group(n=151,85 benign,66 malignant).First,univariate analysis was performed to screen for statistically significant predictors of nodules nature.Then,multivariate regression analysis was performed to screen for independent predictors of nodules nature.Finally,the prediction model of PN nature was constructed by logistic regression analysis.Subsequently,the validation group data were entered into the proposed model and Mayo clinic(Mayo)model,veterans affairs(VA)model,Brock University(Brock)model,Peking University(PKU)model and Guangzhou Medical University(GZMU)model,respectively.PN malignancy probability was calculated.The receiver operating characteristic(ROC)curves were plotted.The diagnostic efficiency of each model was compared according to the area under the curve(AUC).Results There were statistically significant variables including age,family history of cancer,maximum nodule diameter,nodule type,upper lobe of lung,calcification,vascular convergence sign,lobulation,clear border,spiculation,and serum CEA,SCCA,CYFRA21-1 using univariate analysis.Multiple regression analysis showed that age,CEA,clear border,CYFRA21-1,SCCA,upper lobe of lung,maximum nodule diameter,family history of cancer,spiculation and nodule type were independent predictors of PN nature.The prediction model equation constructed in this study is as follows:f(x)= ex/(1+ex),X=(-6.318 8+0.020 8×Age+0.527 4×CEA-0.928 4×clear border+0.294 6×Cyfra21-1+0.294×maximum nodule diameter+1.220 1×family history of cancer +0.573 2×upper lobe of lung +0.064 8×SCCA +1.461 5×Spiculation +1.497 6×nodule type).The AUC(0.799 vs 0.659,0.650)of the proposed model was significantly higher compared with Mayo model and VA model,and there were statistically significant differences(Z=3.029,2.638,P=0.003,0.008).However,compared with Brock model,PKU model and GZMU model,the differences of AUC(0.799 vs 0.762,0.773,0.769)were not statistically significant(Z=1.063,0.686,0.757,P=0.288,0.493,0.449).Conclusion The prediction model for PN nature established in this study is accurate and reliable,which can help clinics with early diagnosis and early intervention,and this prediction model deserves to be popularized.
4.Bioactive Determination of Anfibatide
Xiangrong DAI ; Jie LIANG ; Tao JIANG ; Gang LI ; Leiming XU
Herald of Medicine 2024;43(3):431-435
Objective To screen and establish a method for determining the biological activity of anfibatide.Meth-ods Three methods of light transmittance aggregometry(LTA),whole blood electrical impedance aggregometry,and continuous platelet count method were compared and studied.And the constant platelet counting method was chosen and verified to detect the biological activity of anfibatide.Results The RSD values of anfibatide biological activity detected by LTA,whole blood electri-cal impedance aggregometry,and continuous platelet count method were 10.3%,14.0%,and 3.6%,respectively.RSD of repeat-ability of 6 parallel test articles was 11.0%.The RSD of intermediate precision of 12 test articles for different personnel was 9.8%,and the inhibition rate of anfibatide was linear in the range of 0.3-0.5 U.The correlation coefficient was more than 0.990.The ac-tivity of three batches of anfibatide was determined,and the inhibition rate was 49.9%~53.6%.Conclusion The continuous platelet count method for determining anfibatide activity was established and verified,which can be used for quality control for an-fibatide activity since the precision and detection limit of the method met the requirement for activity assay of biological products.
5.Comparison of MRI standard coronal and multi-planar reconstruction for assessing anterolateral ligament in knee joint
Yu LIU ; Lixue WANG ; Jie LI ; Xiangrong YU ; Zhuozhao ZHENG
Chinese Journal of Medical Imaging Technology 2024;40(2):266-269
Objective To compare the value of standard coronal MRI and multi-planar reconstruction(MPR)images for evaluation of anterolateral ligament(ALL).Methods Data of 130 patients who underwent knee joint MR examination were retrospectively analyzed,including standard coronal MRI and MPR images.ALL were identified on standard coronal MRI and MPR images and classified as fully visible,partially visible or invisible.The visibility of bilateral ALL on both standard coronal MRI and MPR images were compared,while Kappa test was used to evaluate the consistency on both kinds of images.Results Among 130 cases,on standard coronal MRI and MPR images,the left ALL was fully visible in 83 and 93 cases,partially visible in 21 and 12 cases but invisible cases in 26 and 25 cases,respectively,while the right side ALL was fully visible in 66 and 80 cases,partially visible cases in 29 and 15 cases but invisible cases each in 35 cases,respectively.Significant difference of visibility of bilateral ALL were found between standard coronal MRI and MPR images(both P<0.05),both with excellent consistency(both Kappa>0.80).Conclusion MPR could display bilateral ALL better than standard coronal MRI.If the scanning conditions for MPR could not be met,standard coronal MRI might be used to evaluate ALL rather accurately.
6.Comparison on Policies for Technological Achievement Transformation through Pricing and Investment in Public Hospi-tals
Juan LI ; Hongyao MA ; Xiangrong ZHANG
Chinese Health Economics 2024;43(8):11-15
More and more attention is being paid by all parties to the use of pricing and investment for achievement transforma-tion.It is of great significance to enhance the technological transformation ability and economic operation and management ability of public hospitals.Beijing,Shanghai,and Shenzhen have explored the introduction of local special policies to support local public hos-pitals in converting results through priced investment.However,compared with the mature support policies of relevant national regula-tory departments for universities,the improvement are still needed.It compared the pricing and investment policies of universities and relevant local public hospitals from key aspects and contents such as decision-making power of pricing and investment,share-holding platform requirements,completion reward standards,and tax preferential policies,and analyzed the shortcomings of pricing and investment policies in public hospitals.Then it proposed some suggestions,such as exploring innovative models of achievement transformation and shareholding platforms which suitable for public hospitals,further clarifying the content of decision-making exemp-tion policies and asset loss handling procedures.It puts forward countermeasures and suggestions to better promote the transformation of scientific and technological achievements in public hospitals.
7.Comparison on Policies for Technological Achievement Transformation through Pricing and Investment in Public Hospi-tals
Juan LI ; Hongyao MA ; Xiangrong ZHANG
Chinese Health Economics 2024;43(8):11-15
More and more attention is being paid by all parties to the use of pricing and investment for achievement transforma-tion.It is of great significance to enhance the technological transformation ability and economic operation and management ability of public hospitals.Beijing,Shanghai,and Shenzhen have explored the introduction of local special policies to support local public hos-pitals in converting results through priced investment.However,compared with the mature support policies of relevant national regula-tory departments for universities,the improvement are still needed.It compared the pricing and investment policies of universities and relevant local public hospitals from key aspects and contents such as decision-making power of pricing and investment,share-holding platform requirements,completion reward standards,and tax preferential policies,and analyzed the shortcomings of pricing and investment policies in public hospitals.Then it proposed some suggestions,such as exploring innovative models of achievement transformation and shareholding platforms which suitable for public hospitals,further clarifying the content of decision-making exemp-tion policies and asset loss handling procedures.It puts forward countermeasures and suggestions to better promote the transformation of scientific and technological achievements in public hospitals.
8.Comparison on Policies for Technological Achievement Transformation through Pricing and Investment in Public Hospi-tals
Juan LI ; Hongyao MA ; Xiangrong ZHANG
Chinese Health Economics 2024;43(8):11-15
More and more attention is being paid by all parties to the use of pricing and investment for achievement transforma-tion.It is of great significance to enhance the technological transformation ability and economic operation and management ability of public hospitals.Beijing,Shanghai,and Shenzhen have explored the introduction of local special policies to support local public hos-pitals in converting results through priced investment.However,compared with the mature support policies of relevant national regula-tory departments for universities,the improvement are still needed.It compared the pricing and investment policies of universities and relevant local public hospitals from key aspects and contents such as decision-making power of pricing and investment,share-holding platform requirements,completion reward standards,and tax preferential policies,and analyzed the shortcomings of pricing and investment policies in public hospitals.Then it proposed some suggestions,such as exploring innovative models of achievement transformation and shareholding platforms which suitable for public hospitals,further clarifying the content of decision-making exemp-tion policies and asset loss handling procedures.It puts forward countermeasures and suggestions to better promote the transformation of scientific and technological achievements in public hospitals.
9.Comparison on Policies for Technological Achievement Transformation through Pricing and Investment in Public Hospi-tals
Juan LI ; Hongyao MA ; Xiangrong ZHANG
Chinese Health Economics 2024;43(8):11-15
More and more attention is being paid by all parties to the use of pricing and investment for achievement transforma-tion.It is of great significance to enhance the technological transformation ability and economic operation and management ability of public hospitals.Beijing,Shanghai,and Shenzhen have explored the introduction of local special policies to support local public hos-pitals in converting results through priced investment.However,compared with the mature support policies of relevant national regula-tory departments for universities,the improvement are still needed.It compared the pricing and investment policies of universities and relevant local public hospitals from key aspects and contents such as decision-making power of pricing and investment,share-holding platform requirements,completion reward standards,and tax preferential policies,and analyzed the shortcomings of pricing and investment policies in public hospitals.Then it proposed some suggestions,such as exploring innovative models of achievement transformation and shareholding platforms which suitable for public hospitals,further clarifying the content of decision-making exemp-tion policies and asset loss handling procedures.It puts forward countermeasures and suggestions to better promote the transformation of scientific and technological achievements in public hospitals.
10.Comparison on Policies for Technological Achievement Transformation through Pricing and Investment in Public Hospi-tals
Juan LI ; Hongyao MA ; Xiangrong ZHANG
Chinese Health Economics 2024;43(8):11-15
More and more attention is being paid by all parties to the use of pricing and investment for achievement transforma-tion.It is of great significance to enhance the technological transformation ability and economic operation and management ability of public hospitals.Beijing,Shanghai,and Shenzhen have explored the introduction of local special policies to support local public hos-pitals in converting results through priced investment.However,compared with the mature support policies of relevant national regula-tory departments for universities,the improvement are still needed.It compared the pricing and investment policies of universities and relevant local public hospitals from key aspects and contents such as decision-making power of pricing and investment,share-holding platform requirements,completion reward standards,and tax preferential policies,and analyzed the shortcomings of pricing and investment policies in public hospitals.Then it proposed some suggestions,such as exploring innovative models of achievement transformation and shareholding platforms which suitable for public hospitals,further clarifying the content of decision-making exemp-tion policies and asset loss handling procedures.It puts forward countermeasures and suggestions to better promote the transformation of scientific and technological achievements in public hospitals.

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